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Preoperative Risk Factor Analysis and Dynamic Online Nomogram Development for Early Infections Following Primary Hip Arthroplasty in Geriatric Patients with Hip Fracture
BACKGROUND: Hip arthroplasty is in increasing demand with the aging of the world population, and early infections, such as pneumonia, surgical site infection (SSI), and urinary tract infection (UTI), are uncommon but fatal complications following hip arthroplasty. This study aimed to identify preope...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9790145/ https://www.ncbi.nlm.nih.gov/pubmed/36575659 http://dx.doi.org/10.2147/CIA.S392393 |
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author | Cheng, Xinqun Liu, Yan Wang, Weitong Yan, Jincheng Lei, Xiang Wu, Haifeng Zhang, Yingze Zhu, Yanbin |
author_facet | Cheng, Xinqun Liu, Yan Wang, Weitong Yan, Jincheng Lei, Xiang Wu, Haifeng Zhang, Yingze Zhu, Yanbin |
author_sort | Cheng, Xinqun |
collection | PubMed |
description | BACKGROUND: Hip arthroplasty is in increasing demand with the aging of the world population, and early infections, such as pneumonia, surgical site infection (SSI), and urinary tract infection (UTI), are uncommon but fatal complications following hip arthroplasty. This study aimed to identify preoperative risk factors independently associated with early infections following primary arthroplasty in geriatric hip fracture patients, and to develop a prediction nomogram. METHODS: Univariate and multivariate logistical analyses were performed to identify the independent risk factors for early infections, which were combined and transformed into a nomogram model. The prediction model was evaluated by using the area under the receiver operating characteristic curve (AUC), Hosmer–Lemeshow test, concordance index (C-index), 1000 bootstrap replications, decision curve analysis (DCA), and calibration curve. RESULTS: One thousand eighty-four eligible patients got included and 7 preoperative variables were identified to be independently associated with early infections, including heart disease (odds ratio (OR): 2.17; P: 0.026), cerebrovascular disease (OR: 2.25; P: 0.019), liver disease (OR: 8.99; P: <0.001), time to surgery (OR: 1.10; P: 0.012), hematocrit (<lower limit; OR: 3.72; P: 0.015), the platelet-to-mean platelet volume ratio (PMR; >44.52; OR: 2.73; P: 0.047), and high-sensitivity C-reactive protein (HCRP; >78.64mg/L; OR: 3.71; P: <0.001). For the nomogram model, AUC was 0.807 (95% confidence interval (CI): 0.742–0.873), the Hosmer-Lemeshow test demonstrated no overfitting (P = 0.522), and C-index was 0.807 (95% CI: 0.742–0.872) with corrected value of 0.784 after 1000 bootstrapping validations. Moreover, the calibration curve and DCA exhibited the tools’ good prediction consistency and clinical practicability. CONCLUSION: Heart disease, cerebrovascular disease, liver disease, time to surgery, hematocrit, PMR, and HCRP were significant preoperative predictors for early infections following primary arthroplasty in elderly hip fracture patients, and the converted nomogram model had strong discriminatory ability and translatability to clinical application. |
format | Online Article Text |
id | pubmed-9790145 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-97901452022-12-26 Preoperative Risk Factor Analysis and Dynamic Online Nomogram Development for Early Infections Following Primary Hip Arthroplasty in Geriatric Patients with Hip Fracture Cheng, Xinqun Liu, Yan Wang, Weitong Yan, Jincheng Lei, Xiang Wu, Haifeng Zhang, Yingze Zhu, Yanbin Clin Interv Aging Original Research BACKGROUND: Hip arthroplasty is in increasing demand with the aging of the world population, and early infections, such as pneumonia, surgical site infection (SSI), and urinary tract infection (UTI), are uncommon but fatal complications following hip arthroplasty. This study aimed to identify preoperative risk factors independently associated with early infections following primary arthroplasty in geriatric hip fracture patients, and to develop a prediction nomogram. METHODS: Univariate and multivariate logistical analyses were performed to identify the independent risk factors for early infections, which were combined and transformed into a nomogram model. The prediction model was evaluated by using the area under the receiver operating characteristic curve (AUC), Hosmer–Lemeshow test, concordance index (C-index), 1000 bootstrap replications, decision curve analysis (DCA), and calibration curve. RESULTS: One thousand eighty-four eligible patients got included and 7 preoperative variables were identified to be independently associated with early infections, including heart disease (odds ratio (OR): 2.17; P: 0.026), cerebrovascular disease (OR: 2.25; P: 0.019), liver disease (OR: 8.99; P: <0.001), time to surgery (OR: 1.10; P: 0.012), hematocrit (<lower limit; OR: 3.72; P: 0.015), the platelet-to-mean platelet volume ratio (PMR; >44.52; OR: 2.73; P: 0.047), and high-sensitivity C-reactive protein (HCRP; >78.64mg/L; OR: 3.71; P: <0.001). For the nomogram model, AUC was 0.807 (95% confidence interval (CI): 0.742–0.873), the Hosmer-Lemeshow test demonstrated no overfitting (P = 0.522), and C-index was 0.807 (95% CI: 0.742–0.872) with corrected value of 0.784 after 1000 bootstrapping validations. Moreover, the calibration curve and DCA exhibited the tools’ good prediction consistency and clinical practicability. CONCLUSION: Heart disease, cerebrovascular disease, liver disease, time to surgery, hematocrit, PMR, and HCRP were significant preoperative predictors for early infections following primary arthroplasty in elderly hip fracture patients, and the converted nomogram model had strong discriminatory ability and translatability to clinical application. Dove 2022-12-21 /pmc/articles/PMC9790145/ /pubmed/36575659 http://dx.doi.org/10.2147/CIA.S392393 Text en © 2022 Cheng et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Cheng, Xinqun Liu, Yan Wang, Weitong Yan, Jincheng Lei, Xiang Wu, Haifeng Zhang, Yingze Zhu, Yanbin Preoperative Risk Factor Analysis and Dynamic Online Nomogram Development for Early Infections Following Primary Hip Arthroplasty in Geriatric Patients with Hip Fracture |
title | Preoperative Risk Factor Analysis and Dynamic Online Nomogram Development for Early Infections Following Primary Hip Arthroplasty in Geriatric Patients with Hip Fracture |
title_full | Preoperative Risk Factor Analysis and Dynamic Online Nomogram Development for Early Infections Following Primary Hip Arthroplasty in Geriatric Patients with Hip Fracture |
title_fullStr | Preoperative Risk Factor Analysis and Dynamic Online Nomogram Development for Early Infections Following Primary Hip Arthroplasty in Geriatric Patients with Hip Fracture |
title_full_unstemmed | Preoperative Risk Factor Analysis and Dynamic Online Nomogram Development for Early Infections Following Primary Hip Arthroplasty in Geriatric Patients with Hip Fracture |
title_short | Preoperative Risk Factor Analysis and Dynamic Online Nomogram Development for Early Infections Following Primary Hip Arthroplasty in Geriatric Patients with Hip Fracture |
title_sort | preoperative risk factor analysis and dynamic online nomogram development for early infections following primary hip arthroplasty in geriatric patients with hip fracture |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9790145/ https://www.ncbi.nlm.nih.gov/pubmed/36575659 http://dx.doi.org/10.2147/CIA.S392393 |
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